Distribution and etiology of chronic respiratory diseases in primary healthcare departments in Cape Verde.

BACKGROUND AND OBJECTIVE: Data on chronic respiratory diseases (CRD) are scarce or unavailable in most African countries. We aimed to determine the prevalence of CRD and associated risk factors in Cape Verde, at the primary healthcare level. METHODS: In the frame of the Global Alliance Against Chronic Respiratory Diseases, a cross-sectional study was carried out in October 2006 in 3256 outpatients (2142 women) (median age of 30 years) seeking care at primary healthcare departments, through a standardized interview questionnaire during two weeks. RESULTS: The prevalence of emphysema, tuberculosis, chronic bronchitis, rhinoconjunctivitis and asthma were 0.7%, 2%, 4.5%, 12.3% and 6.2%, respectively. Current smoking was associated with emphysema (OR: 3.36; 95% CI: 0.97-11.40) and tuberculosis (OR: 2.14; 95% CI: 1.07-4.30), ever exposed to a dusty workplace with chronic bronchitis (OR: 2.20; CI 95%: 1.50-3.21) and rhinoconjunctivitis (OR: 1.56; CI 95%: 1.23-1.98) and cooking or heating using an open fire with asthma (OR: 1.59; CI 95%: 1.16-2.19). The estimates of attributable risks percent indicated that, in the sample, a noticeable part of CRD could be attributed to active smoking, exposure to dust and biomass. Results varied according to gender, particularly regarding current smoking which was more important for men. CONCLUSIONS: Tobacco smoking, exposure to dust at work and using an open fire were important risk factors for CRD. Our results suggest that if actions were taken in order to reduce the aforementioned exposures, an important CRD decrease could be achieved.

Allergic Rhinitis and its Impact on Asthma (ARIA): achievements in 10 years and future needs.

Allergic rhinitis (AR) and asthma represent global health problems for all age groups. Asthma and rhinitis frequently coexist in the same subjects. Allergic Rhinitis and its Impact on Asthma (ARIA) was initiated during a World Health Organization workshop in 1999 (published in 2001). ARIA has reclassified AR as mild/moderate-severe and intermittent/persistent. This classification closely reflects patients' needs and underlines the close relationship between rhinitis and asthma. Patients, clinicians, and other health care professionals are confronted with various treatment choices for the management of AR. This contributes to considerable variation in clinical practice, and worldwide, patients, clinicians, and other health care professionals are faced with uncertainty about the relative merits and downsides of the various treatment options. In its 2010 Revision, ARIA developed clinical practice guidelines for the management of AR and asthma comorbidities based on the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) system. ARIA is disseminated and implemented in more than 50 countries of the world. Ten years after the publication of the ARIA World Health Organization workshop report, it is important to make a summary of its achievements and identify the still unmet clinical, research, and implementation needs to strengthen the 2011 European Union Priority on allergy and asthma in children.

Prioritised research agenda for prevention and control of chronic respiratory diseases.

The 2008-2013 World Health Organization (WHO) action plan on noncommunicable diseases (NCDs) includes chronic respiratory diseases as one of its four priorities. Major chronic respiratory diseases (CRDs) include asthma and rhinitis, chronic obstructive pulmonary disease, occupational lung diseases, sleep-disordered breathing, pulmonary hypertension, bronchiectiasis and pulmonary interstitial diseases. A billion people suffer from chronic respiratory diseases, the majority being in developing countries. CRDs have major adverse effects on the life and disability of patients. Effective intervention plans can prevent and control CRDs, thus reducing morbidity and mortality. A prioritised research agenda should encapsulate all of these considerations in the frame of the global fight against NCDs. This requires both CRD-targeted interventions and transverse NCD programmes which include CRDs, with emphasis on health promotion and disease prevention.

Integration of GARD Turkey national program with other non-communicable diseases plans in Turkey.

For the prevention and control of non-communicable diseases (NCD), an action plan on NCDs is intended to support coordinated, comprehensive and integrated implementation of strategies and evidence-based interventions across individual diseases and risk factors, especially at the national and regional levels by World Health Organization (WHO). The Global Alliance against Chronic Respiratory Diseases (GARD) is making every attempt to align with WHO's non-communicable diseases action plan. GARD activities have been commenced in over 40 countries and in 11 countries an integrated NCD action plan is being prepared or has already been initiated. This integrated approach of GARD has also targeted to GARD Turkey project. The Turkish Ministry of Health has decided to apply this national control program in conformity with other NCD action plans. This article is intended to summarize these integration efforts of GARD Turkey (the National Control Program on Chronic Airway Diseases) with other NCD national programs.

Correction to: Vilnius Declaration on chronic respiratory diseases: multisectoral care pathways embedding guided self-management, mHealth and air pollution in chronic respiratory diseases.

An amendment to this paper has been published and can be accessed via the original article.

Under-report and underdiagnosis of chronic respiratory diseases in an African country.

BACKGROUND: Chronic respiratory diseases (CRD) are greatly underestimated. The aim of this study was to assess the burden associated with reported CRD and chronic obstructive pulmonary disease, as defined on the basis of various standardized criteria, by estimating their point prevalence in a sample of individuals attending the Primary Health Care (PHC) level and Emergency Room (ER) Departments in Cape Verde (CV) archipelago. The second aim of the study was to identify factors related to airways obstruction and reported CRD in this population. METHODS: A cross-sectional study was carried out in CV during 2 weeks. Outpatients aged more than 20 years seeking care at PHC level and ER answered a standardized questionnaire and were subjected to spirometry, independently of their complaint. Two criteria for airways obstruction were taken into account: forced expiratory volume (FEV(1)) <80% of the predicted value and FEV(1)/forced vital capacity (FVC) ratio <0.70. RESULTS: A total of 274 individuals with a satisfactory spirometry were included. 22% of the individuals had a FEV(1) < 80%. Individuals older than 46 years had a higher risk of having airways obstruction. Asthma diagnosis (11%) had a clear association with airways obstruction. Smoking was a risk factor for a lower FEV(1). Working in a dust place and cooking using an open fire were both related to chronic bronchitis and asthma diagnosis. CONCLUSION: Under-report and underdiagnosis of chronic respiratory conditions seem to be a reality in CV just as in other parts of the world. To improve diagnosis, our results reinforce the need of performing a spirometry.

Chronic respiratory diseases at primary health care level in Georgia: the results of the pilot study.

BACKGROUND AND AIM: Millions of people suffer from chronic respiratory diseases (CRD). To address this serious global health problem WHO formed the Global Alliance against Chronic Respiratory Diseases (GARD). Chronic obstructive pulmonary disease (COPD) is a major priority of GARD due to high chronic morbidity and mortality; however, there is still little prevalence data available. The prevalence of COPD in Georgia, as well as other CRD, is suspected to be high. METHODS: GARD Pilot Survey (GAPS) in Georgia had been carried out by the Georgian Respiratory Association. The survey was conducted in the Sagarejo and Mtskheta districts with total population of about 70.000. All subjects provided information on asthma, bronchitis, respiratory symptoms, smoking, allergic conditions, CRD comorbidity and lifestyle via an interviewer-administered questionnaire. A total of 3,646 questionnaires were analysed. RESULTS: It was discovered that official data concerning allergic rhinitis, TB and asthma are almost equal, but readings in relation to CRD are about five times lower according to official data of the Ministry of Health of Georgia. The data results: for allergic rhinitis - 218 in GAPS vs. 177 in the official statistics (for 100.000 population); for TB -105 in GAPS vs. 147 in the official statistics; for asthma -250 in GAPS vs. 374 in the official statistics; the data about CRD according to our survey is almost five times higher - 365 in GAPS vs. 84 in the official statistics (for 100.000 population). CONCLUSIONS: It is necessary to expand the survey to the entire country population. Country results are likely to be useful and interesting for local doctors and managers, as well as for officials.

Vilnius Declaration on chronic respiratory diseases: multisectoral care pathways embedding guided self-management, mHealth and air pollution in chronic respiratory diseases.

BACKGROUND: Over 1 billion people suffer from chronic respiratory diseases such as asthma, COPD, rhinitis and rhinosinusitis. They cause an enormous burden and are considered as major non-communicable diseases. Many patients are still uncontrolled and the cost of inaction is unacceptable. A meeting was held in Vilnius, Lithuania (March 23, 2018) under the patronage of the Ministry of Health and several scientific societies to propose multisectoral care pathways embedding guided self-management, mHealth and air pollution in selected chronic respiratory diseases (rhinitis, chronic rhinosinusitis, asthma and COPD). The meeting resulted in the Vilnius Declaration that was developed by the participants of the EU Summit on chronic respiratory diseases under the leadership of Euforea. CONCLUSION: The Vilnius Declaration represents an important step for the fight against air pollution in chronic respiratory diseases globally and has a clear strategic relevance with regard to the EU Health Strategy as it will bring added value to the existing public health knowledge.

Allergic Rhinitis and its Impact on Asthma update (ARIA 2008). The perspective from Spain.

Allergic rhinitis is a global health problem. Over 600 million patients suffer from this disease worldwide. ARIA (Allergic Rhinitis and its Impact on Asthma), an evidence-based document, was produced and published in 2001 using an extensive review of the available literature. The ARIA 2008 update was recently published and covers tertiary prevention of allergy, pharmacologic treatments, and immunotherapy. Nonallergic rhinitis is still a controversial area and may pose some treatment problems. Another important aspect of the ARIA update is the comorbidity of allergic rhinitis, in particular, asthma. The recommendations of the 2008 ARIA Update, as in 2001, are that patients with allergic rhinitis, particularly if persistent, should be evaluated for asthma, patients with asthma should be evaluated for rhinitis, and an effective and safe combination strategy should be used to treat diseases of the upper and lower airways. Over the last few years, severa studies performed in Spain report new data on the prevalence of allergic rhinitis sensitivity to common aeroallergens, comorbidity of allergic rhinitis and asthma, and impact on quality of life. The studies reviewed in this manuscript confirm--as do those from other developed countries--the enormous impact of the disease on society and health care in Spain.

Allergic Rhinitis and its impact on asthma update (ARIA 2008). The Belgian perspective.

Allergic rhinitis is a major chronic respiratory disease because of its prevalence, impacts on quality of life and work/school performance, economic burden, and links with asthma. Evidence based guidelines and recommendations for the diagnosis and management have been published in the first Allergic Rhinitis and its Impact on Asthma (ARIA) document. This document has now been updated: ARIA 2008. In this article, it is aimed to summarize the newly updated and published version of "Allergic Rhinitis and its Impact on Asthma (ARIA) 2008" in a Belgian perspective.

[Global alliance against chronic respiratory diseases]. / Swiatowy Sojusz przeciwko Przewleklym Chorobom Ukladu Oddechowego.

Hundreds of millions of people of all ages suffer from chronic respiratory diseases which include asthma and respiratory allergies, chronic obstructive pulmonary disease, occupational lung diseases and pulmonary hypertension. More than 500 million patients live in developing countries or in deprived populations. Chronic respiratory diseases are increasing in prevalence. Although the cost of inaction is clear and unacceptable, chronic respiratory diseases and their risk factors receive insufficient attention from the healthcare community, government officials, media, patients and families. The Fifty-Third World Health Assembly recognised the enormous human suffering caused by chronic diseases and requested the World Health Organization (WHO) Director General to give priority to the prevention and control of chronic diseases, with special emphasis on developing countries. This led to the formation of the WHO Global Alliance against Chronic Respiratory Diseases (GARD). GARD is a voluntary alliance of organisations, institutions and agencies working towards a common vision to improve global lung health according to local needs. GARD is developed in a stepwise approach using the following three planning steps: estimate population need and advocate action; formulate and adopt policy; and identify policy implementation steps.

Erratum to: Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5).

[This corrects the article DOI: 10.1186/s13601-016-0116-9.].

Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5).

Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) focuses on the integrated care of chronic diseases. Area 5 (Care Pathways) was initiated using chronic respiratory diseases as a model. The chronic respiratory disease action plan includes (1) AIRWAYS integrated care pathways (ICPs), (2) the joint initiative between the Reference site MACVIA-LR (Contre les MAladies Chroniques pour un VIeillissement Actif) and ARIA (Allergic Rhinitis and its Impact on Asthma), (3) Commitments for Action to the European Innovation Partnership on Active and Healthy Ageing and the AIRWAYS ICPs network. It is deployed in collaboration with the World Health Organization Global Alliance against Chronic Respiratory Diseases (GARD). The European Innovation Partnership on Active and Healthy Ageing has proposed a 5-step framework for developing an individual scaling up strategy: (1) what to scale up: (1-a) databases of good practices, (1-b) assessment of viability of the scaling up of good practices, (1-c) classification of good practices for local replication and (2) how to scale up: (2-a) facilitating partnerships for scaling up, (2-b) implementation of key success factors and lessons learnt, including emerging technologies for individualised and predictive medicine. This strategy has already been applied to the chronic respiratory disease action plan of the European Innovation Partnership on Active and Healthy Ageing.

Questionnaire on health systems and national resources for control of respiratory health in low-income countries.

BACKGROUND: Due to increased exposure to risk factors such as ageing and tobacco smoking, chronic respiratory diseases (CRDs) have become a major cause of morbidity and mortality worldwide. Data on CRDs and their management in developing countries (DC) are nevertheless sparse and not comparable. OBJECTIVE: To implement and validate a standardised self-administered questionnaire to be proposed to health authorities to assess the resources of their health system for dealing with respiratory diseases. METHODS: The questionnaire concerned social security, description of the health system, human resources available within the system, initial training and continuing education of health personnel, existence of a list of essential drugs, vaccine coverage and specific resources involved in CRD and tobacco control. RESULTS: The validity of the criteria of the questionnaire was tested in Reunion Island, where health data are accessible and reliable, and was found to be satisfactory. Its acceptability and relevance were deemed appropriate in Tunisia and in Mozambique. CONCLUSION: The self-administered questionnaire is a simple, reliable and cheap tool. Although designed for the study of respiratory diseases, it can easily be transposed and adapted to other pathologies.

[Quantatitative evaluation of food consumption in epidemiological studies of cardiovascular diseases]. / Kolichestvennaia otsenka potrebleniia pishchevykh veshchestv, v epidemiologicheskikh issledovaniiakh serdechno-sosudistykh zabolevanii

On the basis of a brief calculation technique for foodstuffs a chart of the chemical composition of food was compiled, in which the most popular foodstuffs were averaged and classified according to their chemical similarity into 12 groups and 162 items. To check the correctness of the selection of the averaged units 21 males, aged 40 to 59 years, were questioned. The obtained data on the whole food consumed on the preceeding day were calculated in two variants: with the brief variant of calculations the averaged foodstuffs were used in accordance with the devised chart, with the long-term method the used data were retrieved from the available tables of the chemical composition of each product individually. A comparison of the results of calculations of the 21 daily rations obtained with the aid of the above two methods has demonstrated that the differences were absolutely negligible for total lipids, saturated, mono- and polynonsaturated fatty acids, total carbohydrates, refined and nonrefined sugar, compound carbohydrates, alcohol and the total caloric content of the food. The difference was meaningful for the total protein and cholesterol.

[Organization of collecting and analysis of the data on nutrition in epidemiological study of cardiovascular diseases]. / Organizatsiia sbora i obrabotki dannykh o pitanii v epidemiologicheskom issledovanii serdechno-sosudistykh zabolevanii.

The principles of collecting and analysis of information on nutrition in epidemiological study of cardiovascular diseases by means of electronic computers are described. A special program computes the consumption of 11 nutrients, the calorific value of the diet, and the calorie percentage of different nutrients with the exception of cholesterol. Certain coefficients are estimated, such as the ratio between the poly-unsaturated and the saturated fatty acids in the diet, and the ratio between the amount of starch and the total amount of refined and unrefined sugar, Well-trained technical personnel may be entrusted with the collection of the information, its coding, perforation, and feeding into the computer and with the obtainment of the data, which reduces the cost of the study considerably.

[Effect of diet on major risk factors in an organized population]. / Vliianie diety na uroven' osnovnykh faktorov riska v organizovannoi populiatsii.

In the organized population, 364 male subjects aged 20-59 years (those with dyslipoproteinemias and borderline hypertension and patients with coronary heart disease) were on diet for 6 months, which resulted in a significant drop in plasma cholesterol, triglycerides, systolic and diastolic blood pressures, and body weight by 7.7%, 17%, 3%, 3.7%, and 5.3%, respectively. The portion of fat in the diet was reduced from 40% to 36% of total caloric value and that of sugar was decreased from 13% to 10%, at the same time complex carbohydrates and protein were increased from 8% to 12% and from 15% to 17%, respectively. A multiple stepwise regression analysis was used to define whether different variables were significant in lowering the risk factors.

[Determination of excess body mass in epidemiological studies of cardiovascular diseases]. / Opredelenie izbytochnoi massy tela v épidemiologicheskikh issledovaniiakh serdechno-sosudistykh zabolevanii.

In epidemiological studies of cardiovascular diseases, in order to determine excessive body weight and its significance in the spread and development of ischemic heart disease among different populations it is necessary to use the best index characterizing the height-weight relationships and meeting such requirements as independence of growth and high correlation with weight. Analysis showed that the index weight/height2 may be used to determine excessive weight in 40--59-year-old males living in one of the Moscow districts. A 30.0 kg/m2 or higher value of this index is evidence of excessive increase in body mass.

[Nutrition and risk factors of ischemic heart disease in men of the Chukot Autonomous Region]. / Pitanie i faktory riska ishemicheskoi bolezni serdtsa u muzhchin Chukotskogo avtonomnogo okruga.

The relationship between the nutritional status and the major risk factors of CHD has been studied in the indigenous and nonindigenous inhabitants of the Chukot Autonomous Region. The nutrition of the indigenous tundra inhabitants who show a significantly lower risk factors as compared with nonindigenous citizens living there for over ten years is characterized by a significantly higher proportion of protein of animal origin, a lower calorie intake in general and that of fat, in particular, a lower consumption of starch-containing products and a high consumption of refined sugar. A larger proportion of polyunsaturated fatty acids in food is markedly associated with reduced levels of cholesterol, beta-lipoprotein cholesterol and the diastolic blood pressure in Chukchi inhabitants living on the seacoast as against Chukchi living on the mainland. The detected differences in the level of risk factors are correlated with differences in the nature of nutrition.

[Comparative study of drug and dietary correction of dyslipoproteinemias among the population]. / Sravnitel'noe izuchenie medikamentoznoi i dieticheskoi korrektsii dislipoproteidemii v populiatsii.

A comparative study of diet and drug correction of dyslipoproteinemias in individuals with stable hypercholesterolemia showed that following a month of diet treatment of groups selected for the therapy with probucol and ascorbic acid there was a clear-cut decrease in the level of plasma cholesterol. The administration of probucol in combination with the diet therapy decreased cholesterol by 33.6%, triglycerides by 32.8% and high density lipoprotein cholesterol (HDLC) by 19.7% as compared with the baseline values. Ascorbic acid showed virtually no effect on the lipid spectrum of the blood. Throughout the entire period of treatment, the patients in these groups showed a reduction in the body weight and blood pressure. In the group receiving only drug therapy, probucol use was associated with a statistically significant decrease in both total cholesterol and HDLC, with the HDLC/cholesterol ratio remaining almost unaltered while in the group receiving diet and probucol, the proportion of HDLC with regard to total cholesterol was elevated as against the initial values. The body weight in this group of patients remained actually unaltered.